Today it is known that intestinal permeability plays a major role in the pathogenesis of ulcerative colitis (UC). Colonic permeability is assessed with sucralose test. In our opinion, it is important to study value as non-invasive disease activity marker.Aim:
to determine the diagnostic value of sucralose level in evaluating of disease activity of UC.Methods:
We prospectively included 33 patients with UC and 20 healthy controls. Colonic permeability was assessed by determining of sucralose level in urine using the high performance liquid chromatography. Mean age in UC was 38.03 ± 1.14 years and in control group—30.13 ± 1.5. Severity of UC was assessed by Mayo score: remission—7, mild—11, moderate— 9, severe—6.Results:
Patients with UC showed a significant increasing of colonic permeability—levels of sucralose in urine in patients with active UC (1600 [700.8; 2185.6] nmol/L) was increased compared with remission UC (374.4 [267.2; 481.3] nmol/L) (Р < 0.01) and healthy (819.2 [521.6; 1044.8] nmol/L) (P < 0.01). ROC-analysis has defined the threshold sucralose level for determining an active UC—1314 nmol/L (empirically determined sensitivity—64%, specificity—94%, and AUC—0.79). An analysis of the diagnostic value in determination of active UC relative remission showed that threshold sucralose level was 587 nmol/L, the sensitivity was 86%, specificity—84%, and AUC—0.93. There was the relationship with disease severity of UC. In severe UC level of sucralose was higher—2344 [1483.2; 3355.2] nmol/L than in moderate UC—836 [599.8; 2011.2] nmol/L (P < 0.05) and mild UC—1623.2 [1005.9; 1908.7] nmol/L (P > 0.05).Conclusions:
Level of sucralose in urine is a non-invasive activity marker that allow to differentiate active UC from healthy individuals and remission and have a high diagnostic value. With increasing activity of disease, level of sucralose was increased too.